Vision Disorders and Phosphodiesterase Type 5 Inhibitors

  title={Vision Disorders and Phosphodiesterase Type 5 Inhibitors},
  author={Alan M. Laties},
  journal={Drug Safety},
Phosphodiesterase type 5 (PDE-5) inhibitors (sildenafil, vardenafil and tadalafil) have been in widespread use for the safe and effective treatment of erectile dysfunction (ED) for nearly a decade. During that time, a relatively small number of patients have experienced adverse visual events, including nonarteritic anterior ischaemic optic neuropathy (NAION). In this article, post-marketing reports of adverse visual events along with other relevant literature on ocular safety related to PDE-5… 
Avanafil, a new rapid-onset phosphodiesterase 5 inhibitor for the treatment of erectile dysfunction
It is proposed that avanafil, which displays enhanced selectivity, faster onset of action, and a favorable side-effect profile relative to currently available PDE5 inhibitors, may offer an alternative first line treatment option for men with ED.
Risk of nonarteritic ischaemic optic neuropathy with phosphodiesterase type 5 inhibitors: a systematic review and meta‐analysis
The treatment with phosphodiesterase type 5 inhibitors was not found to be associated with nonarteritic anterior ischaemic optic neuropathy, and further research is needed to study such association, including possible confounding factors.
Phosphodiesterase Inhibitors in Vascular Ischemia: A Case Report and Review of Their Use in Ischemic Conditions
Overall, based on a number of case reports and preliminary animal studies in the literature, sildenafil appears to have a growing significance in the treatment of hand ischemia and there is evidence that phosphodiesterase 5 inhibitors may be used as an adjunct to improving skin flap survival.
Should Central Serous Chorioretinopathy Be Added to the List of Ocular Side Effects of Phosphodiesterase 5 Inhibitors?
The 2 presented cases of CSC after intake of vardenafil or tadalafil with positive dechallenge, rechallenge and second dechallenges reactions provide important arguments for considering CSC as a rare PDE5 inhibitor class-specific side effect.
Anterior Ischemic Optic Neuropathy in a Patient with Erectile Dysfunction: Tadalafil as an Offending Medication
A healthy nonsmoking 42-year-old male with a history of ED presented with acute onset of an inferior visual field defect on the right eye and the administration of Tadalafil was discontinued as a potential causative agent for this condition.
Tadalafil for the treatment of pulmonary arterial hypertension
  • J. Klinger
  • Medicine, Biology
    Expert review of respiratory medicine
  • 2011
The role of cGMP and PDE-5 in PAH is reviewed, the results of recent clinical trials are presented and the role of tadalafil in the treatment of this rare but difficult-to-treat disease is discussed.
A Case of Central Serous Chorioretinopathy after Tadalafil Treatment
Tadalafil (Cialis ® ) is a phosphodiesterase (PDE)-5 inhibitor and predominantly prescribed for the treatment of erectile dysfunction and may induce choroidal vessel engorge-ment leading to leakage across the retinal pigment epithelium and accumulation of subretinal fluid in selected patients.


Optic atrophy after sildenafil use.
Non-arteritic anterior ischemic optic neuropathy (NAION) and phosphodiesterase type-5 inhibitors.
It is not possible to determine whether NAION is directly linked to the use of PDE-5 inhibitors, underlying cardiovascular risk factors, ocular anatomical defects, a combination of these variables, or as yet unidentified factors.
Ocular safety in patients using sildenafil citrate therapy for erectile dysfunction.
No consistent pattern has emerged to suggest any long-term effect of sildenafil on the retina or other structures of the eye or on the ocular circulation, and visual function studies in healthy subjects and in patients with eye disease suggest that sildanafil does not affect visual acuity, visual fields, and contrast sensitivity.
Viagra® (sildenafil citrate) and ophthalmology
PDE5 inhibitors and permanent visual loss
  • R. Tomsak
  • Medicine
    International Journal of Impotence Research
  • 2005
Clinicians are being deluged with queries, without definitive answers, and an ophthalmologic evaluation is discretionary, and appears to be based on either patient desire, patient risk factor profile, or clinician instinct.
Ischemic optic neuropathy in male veterans prescribed phosphodiesterase-5 inhibitors.
Expression of the PDE5 enzyme on human retinal tissue: new aspects of PDE5 inhibitors ocular side effects
It is demonstrated that tadalafil and sildenafil are able to modify the OA flux in a time-dependent manner and the PDE5 enzyme is expressed on retinal and choroid vasculature and has a physiologic role on ganglion and bipolar cells that need to be further investigated.
Sildenafil in erectile dysfunction: a critical review
The impact of sildenafil in special patient populations is considered, namely in men complaining of diabetes mellitus, depression, neurological disorders, renal failure and those who have undergone a radical prostatectomy.
Sildenafil-associated nonarteritic anterior ischemic optic neuropathy.
Tadalafil-associated anterior ischaemic optic neuropathy
A previously undocumented occurrence of NAION is described following the use of the more recently licensed and longer acting drug tadalafil, in the absence of any known systemic or local risk factors.